Search Results (20)

Background: Nodal dendritic cells (DCs) and CD169-positive macrophages, possibly monocyte-derived, cross-present cancer antigens earlier in the proximal node than in the distal node. Methods: We performed immunohistochemical and morphometric analyses to show differences in the distributions of DC-SIGN-, CD68-, and CD169-positive cells in the paratracheal, subcarinal, and hilar nodes from 25 non-small cell lung cancer patients without metastasis. Results: CD169-positive and DC-SIGN-positive cells were colocalized in the subcapsular and paracortical sinuses, whereas CD68-positive, self-renewal alveolar macrophages were present in the medullary sinus. This complementary distribution was more evident in nodes other than hilar nodes. In hilar nodes, the proportion of CD68-positive macrophages usually exceeds 50%. Notably, the proportion of the overlapped cluster between CD169-positive cells and DC-SIGN-positive cells, which likely corresponds to the cross-presentation activity, was almost the same between the hilar and “next-upstream” node (i.e., the paratracheal node for the upper lobe and the subcarinal node for the lower lobe). Monocyte-derived cells occupied a significantly larger area in the hilar nodes of patients with upper lobe cancer than in patients with lower lobe cancer (p = 0.002–0.009). Conclusion: The specific site occupying the lung hilum with collateral vessels seemed to determine the hilar node composite cells. Full article

Mycotoxin contamination in medicinal plants can lead to toxicity, reduced therapeutic efficacy, and economic losses. This contamination has emerged as a significant issue, drawing attention from researchers and research centers worldwide. Over recent decades, numerous analytical studies have addressed mycotoxin contamination in these herbs, evaluating various methods to determine their presence quantitatively and qualitatively. While several reviews have summarized these studies, they often overlook a comprehensive exploration of the mechanisms and influencing factors of mycotoxin contamination in medicinal herbs. Therefore, this review aims to delve into the mechanisms of aflatoxin and ochratoxin contamination in some of the most widespread medicinal herbs, including jujube fruits, lotus seeds, and licorice roots. The factors influencing these mechanisms were also examined, including the physical composition and maturity stages of the herbs. This review concluded that aflatoxin and ochratoxin A contamination of medicinal herbs involves complex interactions between the herbs’ natural defenses, fungal pathogenicity, chemical composition, physical characteristics, and individual plant differences at various maturity stages. Understanding these mechanisms of contamination, and their association with maturity, nutrient profile, and physical development, advances our comprehension of mycotoxin contamination in medicinal herbs. Full article

The susceptibility and mechanism of aflatoxin (AF) contamination in Ziziphus jujuba var. spinosa, whose seeds are important for medicinal use, were evaluated in this study. First, the susceptibility of intact fruits, classified into four maturity groups, to AF accumulation was assessed through artificial contamination with an aflatoxigenic Aspergillus flavus strain. AF analysis revealed that mid-mature fruits were highly susceptible to AF contamination. Next, AF accumulation in seed parts was examined by artificially inoculating A. flavus on intact fruits, showing AF presence in seeds after 30 days of incubation. The susceptibility of jujube kernels to AF accumulation in seed parts was then studied. The artificial inoculation of A. flavus on kernels, classified into three groups based on the pedicel condition, showed no correlation between AF contamination and the pedicel condition, with large fluctuations within each group. Finally, the effect of the hilar region morphology on AF contamination in seeds was investigated. The microscopic investigation of artificially contaminated seeds and AF quantification revealed that variations in AF concentration were linked to differences in the hilar region morphology. Full article

Mucinous cystic neoplasm of the liver (MCN-L) is a rare benign tumor accounting for less than 5% of all liver cysts, with MCN-L in the hilar region being exceptionally uncommon and often misdiagnosed due to its complex presentation. A 48-year-old woman presented with obstructive jaundice following initial laparoscopic drainage of hepatic cysts, where pathology initially indicated benign cystic lesions. Months later, imaging revealed an enlarged cystic lesion in the left liver lobe with intrahepatic bile duct dilation. Further evaluations, including ultrasound, enhanced CT, and MRI, confirmed a large cystic lesion compressing the intrahepatic bile ducts. After a multidisciplinary discussion, hepatic cyst puncture and drainage were performed, temporarily alleviating jaundice. However, she returned with yellowish-brown drainage fluid and worsening jaundice, prompting cyst wall resection. Postoperative pathology confirmed MCN-L. Three months later, jaundice subsided, and a hepatic resection of segment 4 was performed, with pathology confirming low-grade MCN-L. At a 12-month follow-up, the patient showed no abnormalities. This case highlights the diagnostic and therapeutic challenges of MCN-L in the hilar region, as it can easily be mistaken for other liver cystic lesions on imaging. Pathologic examination is essential for definitive diagnosis, and early radical surgical resection is critical to improve prognosis and reduce the risk of malignancy and recurrence. Full article

Malignant hilar biliary obstruction (MHBO) can cause obstructive jaundice and/or cholangitis necessitating appropriate biliary drainage. Endoscopic biliary stenting is the first-choice treatment, especially in unresectable cases, owing to its minimally invasive nature and utility. However, the hilar region is complex because of the branching and curving of bile ducts, making strictures in this area more complicated. Therefore, MHBO stenting is challenging, and treatment strategies have yet to be established. Furthermore, recent advances in antitumor therapies have altered the background surrounding the development of stenting strategies. Therefore, it is necessary to understand and grasp the current evidence well and to accumulate additional evidence reflecting the current situation. This study reviews the current status, issues, and prospects of endoscopic stenting for MHBO, especially in unresectable cases. Full article

Both porcine circovirus (PCV) and porcine parvovirus (PPV) cause various diseases and bring huge economic losses to the global swine industry. PCV2 is associated with several diseases and syndromes, including postweaning multisystemic wasting syndrome (PMWS), porcine dermatitis and nephropathy syndrome (PDNS) and porcine respiratory disease complex (PRDC). The classical PPV is one of the most common causes of reproductive failure in pigs. In this study, tissue samples (tonsil, lung, mesenteric lymph node, hilar lymph node and superficial inguinal lymph node) were collected from pigs with suspected PCV2-associated disease (PCVAD), and viral DNA was extracted. The coinfection of PCV2 and PPV1–5 was detected using the polymerase chain reaction (PCR) method. Phylogenetic analysis based on capsid genes of PCV2, PPV2, PPV3 and PPV5 was conducted. The prevalence rates of PCV2, PPV1, PPV2, PPV3, PPV4 and PPV5 were 51.2%, 15.9%, 36.6%, 19.5%, 14.6% and 10.9% on the individual pig level, respectively. The coinfection rates of PCV2 with PPV1, PPV2, PPV3, PPV4 and PPV5 were 8.5%, 25.6%, 17.1%, 13.4% and 3.7%, respectively. The prevalence of PPV2, PPV3 and PPV4 in PCV2-positive pigs was significantly higher than those in PCV2-negative pigs. Phylogenetic analyses were performed using the neighbor-joining (NJ) method with 1000 bootstraps. The results indicated the existence of PCV2d and two major clusters of PPV2, PPV3 and PPV5 in the Guangxi Autonomous Region. PCV2d was the dominant strain, and the novel PPVs were circulating in domestic pigs in the Guangxi Autonomous Region. The results of this study underline the importance of active surveillance of PCV2d and PPVs from the swine population in this area. Full article

Ultrasonography is an essential part of the diagnostic process of biliary atresia (BA). The characteristic findings of BA include a hilar hyperechoic zone, the triangular cord sign (TCS), an absence of gallbladder contraction after feeding, and gallbladder atrophy. However, approximately 10% of patients with BA have a normal gallbladder. We herein present two cases of BA with normal morphology of the gallbladder as shown by ultrasonography. In the first case, the patient was positive for the TCS, negative for gallbladder atrophy, and positive for contraction of the gallbladder after feeding; the final diagnosis was hilar obstructive BA complicated by pancreaticobiliary maljunction. In the second case, the patient was positive for the TCS, negative for gallbladder atrophy, and negative for contraction of the gallbladder after feeding; the patient also had common bile duct obstruction and stenosis of the hepatic duct in the hilar region. Based on these two cases, we conclude that gallbladder findings are not diagnostic for BA because in some types, the gallbladder may be normal in morphology and even have the capacity for contraction after feeding. Full article

The caper bush has developed different mechanisms to survive in Mediterranean conditions, such as drought tolerance and seed dormancy. Many studies have been carried out to improve the germination of caper seeds, but ultrasound is one of the least studied methodologies in this species. This study aimed to analyze the effects of treatments with an ultrasonic probe processor on the imbibition and germination of caper seeds. After applying the ultrasound treatment using three output powers and three holding times, the seed coat’s disruption level was determined, and the imbibition, viability and germination tests were carried out. Ultrasonication fastens the initial imbibition, but after 48 h of soaking, seed moisture does not present differences compared to non-sonicated seeds. It produces the scarification of the testa but does not affect the tegmen, so moistening occurs through the hilar region, as in control seeds. There is a significant linear and negative correlation between the germination of the seeds and the temperature reached during the sonication treatment, so that temperatures above 40 °C practically annulled the germination. The combination of 20 W and 60 s provided the greatest germination percentage, being the only treatment that statistically improves germination in relation to the control seeds. When the output power and/or holding time were higher, the temperature increased, and the germination percentage statistically decreased. Full article

SMARCA4-deficient non-small cell lung cancer (NSCLC) is a more recently recognized subset of NSCLC. We describe the ¹⁸F-fluorodeoxyglucose (FDG) PET/CT findings in a rare case of SMARCA4-deficient NSCLC and response to therapy. A 45-year-old male patient with a history of heavy smoking (10 years) underwent an ¹⁸F-fluorodeoxyglucose (FDG) PET/CT dynamic (chest) + static (whole-body) scan for diagnosis and pre-treatment staging. ¹⁸F-FDG PET/CT showed an FDG-avid mass in the upper lobe of the left lung (SUV_max of 22.4) and FDG-avid lymph nodes (LN) in the left pulmonary hilar region (SUV_max of 5.7). In addition, there were multiple metastases throughout the body, including in the distant LNs, adrenal glands, bone, left subcutaneous lumbar region, and brain. Pathological findings confirmed SMARCA4-deficient NSCLC. After four cycles of chemotherapy and immune checkpoint inhibitors (ICI), the patient underwent again an ¹⁸F-FDG PET/CT scan (including a dynamic scan) for efficacy evaluation. We report a case that deepens the understanding of the ¹⁸F-FDG PET/CT presentation of SMARCA4-deficient NSCLC as well as dynamic imaging features and parametric characteristics. Full article

Background: Traumatic brain injury (TBI) remains a significant risk factor for post-traumatic epilepsy (PTE). The pathophysiological mechanisms underlying the injury-induced epileptogenesis are under investigation. The dentate gyrus—a structure that is highly susceptible to injury—has been implicated in the evolution of seizure development. Methods: Utilizing the murine unilateral focal control cortical impact (CCI) injury, we evaluated seizure onset using 24/7 EEG video analysis at 2–4 months post-injury. Cellular changes in the dentate gyrus and hilus of the hippocampus were quantified by unbiased stereology and Imaris image analysis to evaluate Prox1-positive cell migration, astrocyte branching, and morphology, as well as neuronal loss at four months post-injury. Isolation of region-specific astrocytes and RNA-Seq were performed to determine differential gene expression in animals that developed post-traumatic epilepsy (PTE⁺) vs. those animals that did not (PTE⁻), which may be associated with epileptogenesis. Results: CCI injury resulted in 37% PTE incidence, which increased with injury severity and hippocampal damage. Histological assessments uncovered a significant loss of hilar interneurons that coincided with aberrant migration of Prox1-positive granule cells and reduced astroglial branching in PTE⁺ compared to PTE⁻ mice. We uniquely identified Cst3 as a PTE⁺-specific gene signature in astrocytes across all brain regions, which showed increased astroglial expression in the PTE⁺ hilus. Conclusions: These findings suggest that epileptogenesis may emerge following TBI due to distinct aberrant cellular remodeling events and key molecular changes in the dentate gyrus of the hippocampus. Full article

A 47-year-old female with cardiac dysfunction and lymphadenopathy underwent ¹⁸FDG PET/CT and ⁶⁸Ga-FAPI-04 imaging for tumor screening. Mild uptake in the left ventricular wall was detected on the oncology ¹⁸FDG PET/CT. True myocardiac-involvement could not be distinguished with physiological uptake. The following ⁶⁸Ga-FAPI-04 showed intense heterogeneous uptake in the left ventricular wall, particularly in the septum and apex area, corresponding with the late gadolinium enhancement regions shown by cardiac MR. Intense uptake was also noted in the mediastinal and bilateral hilar lymph nodes. Endomyocardial biopsy demonstrated sarcoidosis. Full article

Objectives: To evaluate the capability of digital tomosynthesis (DTS) to characterize suspected pulmonary lesions in the so-called hidden areas at chest X-ray (CXR). Materials and Methods: Among 726 patients with suspected pulmonary lesions at CXR who underwent DTS, 353 patients (201 males, 152 females; age 71.5 ± 10.4 years) revealed suspected pulmonary lesions in the apical, hilar, retrocardiac, or paradiaphragmatic lung zones and were retrospectively included. Two readers analyzed CXR and DTS images and provided a confidence score: 1 or 2 = definitely or probably benign pulmonary or extra-pulmonary lesion, or pulmonary pseudo-lesion deserving no further diagnostic work-up; 3 = indeterminate lesion; 4 or 5 = probably or definitely pulmonary lesion deserving further diagnostic work-up by CT. The nature of DTS findings was proven by CT (n = 108) or CXR during follow-up (n = 245). Results: In 62/353 patients the suspected lung lesions were located in the lung apex, in 92/353 in the hilar region, in 59/353 in the retrocardiac region, and in 140/353 in the paradiaphragmatic region. DTS correctly characterized the CXR findings as benign pulmonary or extrapulmonary lesion (score 1 or 2) in 43/62 patients (69%) in the lung apex region, in 56/92 (61%) in the pulmonary hilar region, in 40/59 (67%) in the retrocardiac region, and in 106/140 (76%) in the paradiaphragmatic region, while correctly recommending CT in the remaining cases due to the presence of true solid pulmonary lesion, with the exception of 22 false negative findings (60 false positive findings). DTS showed a significantly (p < 0.05) increased sensitivity, specificity, and overall diagnostic accuracy and area under ROC curve compared to CXR alone. Conclusions: DTS allowed confirmation or exclusion of the presence of true pulmonary lesions in the hidden areas of the chest. Full article

A 41-year-old female underwent a cervical spine CT for the workup of posterior neck pain irradiating to the shoulders for several months. An incidental thyroid nodule was found and classified as Bethesda III on the Fine-needle aspiration cytology (FNAC) results. Three months later, the patient developed mild shortness of breath, dry cough, and fever. Chest X-ray revealed a mild enlargement in the bilateral hilar regions. CT showed mediastinal and bilateral hilar enlarged lymph nodes and pulmonary micronodules. The workup was further completed with a ¹⁸F-FDG PET/CT, showing intense FDG uptake in the mediastinal and bilateral hilar lymph nodes and increased uptake in the thyroid nodule. Endobronchial Ultrasound-guided Transbronchial needle aspiration (EBUS-TBNA) of a left hilar lymph node showed epithelioid non-necrotizing granulomas. Because of the FNAC results, size of the nodule and tracheal shift, thyroid lobectomy was performed one month later. Histopathological results also revealed multiple non-necrotizing epithelioid granulomas, suggesting systemic sarcoidosis with involvement of the thyroid. To our knowledge, this is the first report of thyroid sarcoidosis detected on ¹⁸F-FDG PET/CT. Although an increased FDG uptake in a thyroid nodule is usually suggestive of thyroid malignancy, toxic nodule, or follicular hyperplasia, our case report shows that it could also suggest thyroid sarcoidosis. Full article

KRAS mutation is reportedly associated with poor prognosis in patients with different cancer types. However, mutational data on hilar cholangiocarcinoma are few and controversial. The aim of this study was to evaluate the rate of KRAS mutations in a single-center homogeneous population resected for hilar cholangiocarcinoma and the subsequent impact on prognosis. KRAS mutation status was evaluated in 54 patients undergoing major hepatectomy combined with resection of the main biliary confluence and regional lymphadenectomy for hilar cholangiocarcinoma between 2001 and 2019. Among these 54 patients, 12 (22.2%) had a KRAS mutation. KRAS mutation was not related with pathologic characteristics of the tumor. Five-year overall survival (OS) in patients with KRAS mutation was significantly lower than that observed in patients with KRAS wild type (0 vs. 49.2%, respectively; p = 0.003). In the multivariable analysis; independent predictors of poor OS were KRAS mutation (HR = 5.384; p = 0.003) and lymph node metastases (HR = 2.805; p = 0.023). The results of our study suggested that KRAS mutation in hilar cholangiocarcinoma was not rarely observed. KRAS mutation was an independent strong predictor of poor OS. KRAS mutation analysis should be included in the routine pathologic evaluation of resected hilar cholangiocarcinoma in order to better stratify prognosis Full article

Background and Objectives: Several authors have reported cervical and axillary lymphadenopathies as known side effects following anti-COVID-19 vaccine administration. Few data are available about atypical locations of post-anti-COVID-19 vaccine lymphadenopathy. In this investigation, we evaluated the incidence and prevalence of postvaccine lymphadenopathy ultrasound (US) features in atypical sites. Materials and Methods: In this retrospective study, we retrospectively selected 64 patients on whom US was performed between January and October 2021 due to COVID-19 vaccine-related lymphadenopathy. We investigated lymph node anatomical sites, presence, number, size, shape, cortical profile, hilum outline, superb microvascular imaging (SMI), and elastosonography. Results: A total of 170 nodes were assessed. Atypical location was demonstrated in 5/64 patients (7.8%). In all these cases, atypical nodal involvement was associated with lymphadenopathy in a typical site (axillary, supraclavicular) ipsilateral to the vaccine injection site. Two patients presented lymphadenopathy in the infraclavicular station (3.1%), one in the pectoralis major muscle (1.6%), one in the left arm (1.6%), and one in the nuchal site (1.6%). All lymphadenopathies were oval-shaped, with a median size of 0.9 ± 0.2 cm. US features included a symmetric cortex with hilum evidence (4/6, 60%), vascular signal at SMI in both the hilar region and periphery of lymph node (5/6, 83.3%), and a US elastography pattern resembling that of adjacent tissues (5/6, 83.3%). The median age of patients with lymphadenopathies in an atypical location was 23 years. The main type of vaccine associated with lymph node appearance in atypical sites was Moderna’s mRNA-1273 (60% of patients, 4/6 lymph nodes accounting for 66.7% among atypical locations). Conclusion: Post-COVID-19 vaccine administration lymphadenopathies in an atypical location represent an intense immune response to antigenic stimuli and they may show alarming US traits superimposed on malignant pathologies, which may complicate the patient’s clinical and diagnostic pathway. Despite no distinctive US features between reactive post-COVID-19 vaccination and malignant lymph nodes being available, careful examination of atypical lymph node locations associated with accurate knowledge of patients’ clinical background and delay of US exam to four to six weeks after vaccine injection should be considered. Full article